| 摘要: |
| 目的:探讨罗哌卡因联合右美托咪定局部浸润在缓解扁桃体切除患儿术后疼痛方面的应用价值。方法:选择我院耳鼻喉科择期行扁桃体切除术的患儿60例(ASA分级Ⅰ级,年龄6~12岁),采用随机数表法分为罗哌卡因组(单用组)和罗哌卡因联合右美托咪定组(联用组)各30例。两组患儿在麻醉诱导后用开口器暴露口咽部,分别在扁桃体周围行局部注射:单用组给予0.25%罗哌卡因5 mL,联用组给予0.25%罗哌卡因5 mL和右美托咪定(0.25 μg/kg)的混合液。主管麻醉医师分别于患儿清醒拔管后30 min(T1)、2 h(T2)、4 h(T3)、6 h(T4)、12 h(T5)、24 h(T6)、48 h(T7)、72 h(T8)访视患儿并按FLACC法对患儿的疼痛程度进行评分。记录两组患儿术后72 h追加镇痛药物的情况及术后24 h不良反应的发生情况。结果:联用组T1~ T6的FLACC评分均低于单用组(P均<0.05);两组患儿术后24 h内的恶心呕吐发生率、72 h内追加镇静镇痛药物患儿的比例比较差异均无统计学意义(P均>0.05);两组患儿术后均无呼吸抑制、创面出血等不良反应发生。结论:罗哌卡因联合右美托咪定局部浸润用于患儿扁桃体切除术,可有效减轻术后疼痛,且不增加不良反应。 |
| 关键词: 罗哌卡因 右美托咪定 扁桃体 术后疼痛 |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2018.09.009 |
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| 基金项目: |
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| Ropivacaine Combined with Dexmedetomidine on Postoperative Pain in Children with Tonsillectomy |
| Huang Qingxian, Wang Peng |
| (The Second People's Hospital of Henan Nanyang, Henan Nanyang 473000, China) |
| Abstract: |
| Objective: To probe into the application value of ropivacaine combined with dexmedetomidine in relieving postoperative pain in children with tonsillectomy. Methods: Sixty children (ASA physical status I, with age from 6 to 12 years) undergoing tonsillectomy in otolaryngology department of our hospital were extracted to be divided into ropivacaine group (single-use group) and ropivacaine combined with dexmedetomidine group (combination group), with 30 cases in each group. After anesthesia induction, two groups of children were exposed to oropharynx with a mouth opener and received local injection around tonsil: the single-use group was given 0.25% ropivacaine 5 mL, while the combination group received mixture of 0.25% ropivacaine 5 mL and dexmedetomidine (0.25 μg/kg). The pain level of children according to Face Legs Activity Cry Consolability (FLACC) were recorded after awake and extubated at 30 min (T1), 2 h (T2), 4 h (T3), 6 h (T4), 12 h (T5), 24 h (T6), 48 h (T7) and 72 h (T8) by the competent anesthesiologist. The additional analgesic drugs at 72 hours after surgery and incidence of adverse drug reactions at 24 h after surgery of two groups were recorded. Results: The FLACC in the incidence of nausea and vomiting within 24 hours after surgery and the proportion of children with additional sedative and analgesic drugs within 72 h (P>0.05). No respiratory depression and wound bleeding occurred after surgery in both groups. Conclusion: Ropivacaine combined with dexmedetomidine local infiltration for tonsillectomy can effectively reduce postoperative pain without increasing adverse drug reactions. |
| Key words: ropivacaine dexmetomidine tonsilectomy postoperative pain |
